Pregnancy and perinatal outcome in epileptic women: a population-based study.

OBJECTIVE: To investigate the pregnancy outcome of patients with epilepsy.

STUDY DESIGN: A population-based study comparing all singleton pregnancies of patients with and without epilepsy was performed. Patients lacking prenatal care were excluded from the analysis. Deliveries occurred between the years 1988 and 2002 in a tertiary medical center. Stratified analysis, using a multiple logistic regression model, was performed to control for confounders.

RESULTS: During the study period 139 168 singleton deliveries occurred in our medical center. Of these, 220 (0.2%) were of patients with epilepsy. With the exception of gestational diabetes mellitus (GDM), no other significant differences regarding maternal outcomes were noted between the groups. However, a higher rate of congenital malformations was noted among the epileptic population (7.7% vs. 3.8%; p < 0.001). Also, a higher rate of cesarean deliveries (CD) was found among epileptic women (17.3% vs. 11.55%, p = 0.008). This association was persistent after controlling for possible confounders, using a multivariable analysis (OR = 1.5, 95% CI 1.1-2.3; p = 0.05).

CONCLUSION: The course of pregnancy of patients with epilepsy is favorable, except for higher rates of cesarean deliveries, GDM, and congenital malformations.